J Breast Cancer.  2010 Dec;13(4):409-417. 10.4048/jbc.2010.13.4.409.

Charlson Comorbidity Index as a Predictor of Long-Term Survival after Surgery for Breast Cancer: A Nationwide Retrospective Cohort Study in South Korea

• Woo HK
• Park JH
• Kang HS
• Kim SY
• Lee SI
• Nam HH

• KMID: 2286530
• DOI: http://doi.org/10.4048/jbc.2010.13.4.409

Abstract

PURPOSE
The aim of this article was to evaluate the impact of the Charlson Comorbidity Index (CCI) on long-term survival after surgery for breast cancer in South Korea.
METHODS
The study subjects were 29,562 women patients aged 20 years and older that underwent surgery for breast cancer between 2002 and 2005. The data were obtained from claims submitted to the National Health Insurance. All patients were censored at the follow-up cutoff date of June 30, 2006. Survival curves were estimated by the Kaplan-Meier method. Cox proportional hazards models were used to explore the impact of CCI on all-cause mortality.
RESULTS
After a follow-up time of 47 months, higher all-cause mortality was associated with an increasing CCI. In terms of the 4-year survival rate, among patients with CCI=1, it was 91.1%, among patients with CCI=2 it was 87.8%, and those patients with CCI> or =3 it was 80.2%. Multivariate Cox proportional hazard analysis showed that CCI=1 (hazard ratios [HR], 1.10; 95% confidence interval [CI], 0.97-1.25), CCI=2 (HR, 1.61; 95% CI, 1.31-1.97) and CCI> or =3 (HR, 2.27; 95% CI, 1.59-3.24), were associated with long-term survival.
CONCLUSION
CCI is a strong predictor of long-term survival after surgery for breast cancer. We recommend the use of a validated comorbidity index in the selection of patients for breast surgery.

Keyword

Breast neoplasms; Comorbidity; Surgery; Survival

MeSH Terms

Aged
Breast
Breast Neoplasms
Cohort Studies
Comorbidity
Female
Follow-Up Studies
Humans
National Health Programs
Proportional Hazards Models
Republic of Korea
Retrospective Studies
Survival Rate

Figure

• 

  Figure 1 Kaplan-Meier overall survival curve after surgery for breast cancer according to the Charlson Comorbidity Index (CCI).

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